Stroke in china.

Abstract

HomeStrokeVol. 35, No. 2Stroke in China Free AccessLetterPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessLetterPDF/EPUBStroke in China Tsung O. Cheng, MD Tsung O. ChengTsung O. Cheng Division of Cardiology, George Washington University Medical Center, Washington, DC Search for more papers by this author Originally published22 Jan 2004https://doi.org/10.1161/01.STR.0000115531.90888.A4Stroke. 2004;35:e24Other version(s) of this articleYou are viewing the most recent version of this article. Previous versions: January 22, 2004: Previous Version 1 To the Editor:I read with interest the important article on proportion of different subtypes of stroke in China.1 However, it was unclear to me if stroke due to paradoxical embolism was included or excluded in the study. Because paradoxical embolism is a frequent cause of stroke in the young2,3 and because paradoxical embolism is nowadays a preventable disease,3,4 the knowledge of its frequency in China is extremely important “to provide a scientific base for making an appropriate stroke prevention strategy in the most populous country in the world.”1Paradoxical embolism refers to arterial embolization of a venous thrombus via a patent foramen ovale, atrial septal defect, or fenestrated atrial septal aneurysm.2–7 It is easily diagnosable nowadays by contrast echocardiography.2,8–16 In a recent report published in the same issue of Stroke, a patent foramen ovale, atrial septal aneurysm, the Eustachian valve and right atrial filamentous strands, all of which favor paradoxical embolism, are significantly more prevalent among whites and Hispanics than blacks.17 Thus, such an ethnic difference renders the recognition of their frequency among the Chinese of even greater significance as an important risk factor for stroke in China.1 Zhang L-F, Yang J, Hong Z, Yuan G-G, Zhou B-F, Zhao L-C, Huang Y-N, Chen J, Wu Y-F, for the Collaborative Group of China Multicenter Study of Cardiovascular Epidemiology. Proportion of different subtypes of stroke in China. Stroke. 2003; 34: 2091–2096.LinkGoogle Scholar2 Cheng TO. Predisposing factors in cardiogenic cerebral embolism. Stroke. 1990; 21: 1643.Letter.CrossrefMedlineGoogle Scholar3 Cheng TO. Percutaneous closure of patent foramen ovale is the procedure of choice for paradoxical embolism. Circulation. 2003; 108: e126.Letter.LinkGoogle Scholar4 Cheng TO. Paradoxical embolism: diagnosis and management. J Emerg Med. 2001; 20: 416–417.CrossrefMedlineGoogle Scholar5 Cheng TO. Paradoxical embolism: a diagnostic challenge and its detection during life. Circulation. 1976; 53: 565–568.LinkGoogle Scholar6 Cheng TO. Paradoxic embolism. Am Heart J. 1996; 131: 1238.Letter.Google Scholar7 Cheng TO. Impending paradoxical embolism. Arch Intern Med. 1998; 158: 1720.Letter.CrossrefGoogle Scholar8 Cheng TO. Echocardiography and paradoxical embolism. Ann Intern Med. 1981; 95: 515.Letter.CrossrefMedlineGoogle Scholar9 Cheng TO. Impending paradoxical embolism. Eur Heart J. 1995; 16: 292.Letter.Google Scholar10 Cheng TO. Paradoxical emboli after pulmonary embolus. Presse Med. 1995; 24: 1049.Letter.Google Scholar11 Cheng TO. Impending paradoxical embolism: a transesophageal echocardiographic image. Clin Cardiol. 1999; 22: 328.Letter.MedlineGoogle Scholar12 Cheng TO. Echocardiography in ischaemic cerebrovascular disease. BMJ. 1987; 295: 856.Letter.Google Scholar13 Cheng TO. Paradoxical embolism. Postgrad Med. 1988; 84 (3): 29.Letter.CrossrefMedlineGoogle Scholar14 Cheng TO. Patent foramen ovale in elderly stroke patients. Postgrad Med J. 1991; 67: 1083.Letter.Google Scholar15 Cheng TO. Diagnosis of paradoxic embolism. Int J Cardiol. 1998; 66: 223.Letter.CrossrefMedlineGoogle Scholar16 Cheng TO. Pulmonary embolism and impending paradoxical embolism: a role for echocardiography? Clin Cardiol. 1998; 21: 611.Letter.MedlineGoogle Scholar17 Rodriguez CJ, Homma S, Sacco RL, Di Tullio MR, Sciacca RR, Mohr JP, for PICSS Investigators. Race-ethnic differences in patent foramen ovale, atrial septal aneurysm, and right atrial anatomy among ischemic stroke patients. Stroke. 2003; 34: 2097–2102.LinkGoogle Scholar Previous Back to top Next FiguresReferencesRelatedDetailsCited By Yong M, Xianjun X, Jinghu L and Yunyun F (2018) Effect of health insurance on direct hospitalisation costs for in-patients with ischaemic stroke in China, Australian Health Review, 10.1071/AH16056, 42:1, (39), . February 2004Vol 35, Issue 2 Advertisement Article InformationMetrics https://doi.org/10.1161/01.STR.0000115531.90888.A4PMID: 14739403 Originally publishedJanuary 22, 2004 PDF download Advertisement